Cesarean scar ectopic pregnancy - case series. Diagnosis and treatment at tertiary care hospital

Abstract Cesarean Scar Pregnancy is a rare form of ectopic pregnancy with the incidence increasing due to the increased rate of primary cesarean section. It is potentially life-threatening and can cause serious maternal morbidity and mortality if undetected or misdiagnosed. The aim of this case series is to study clinical presentation, diagnosis, and treatment of caesarean scar pregnancy. We studied 10 confirmed cases of cesarean scar pregnancy treated in department of OBGYN at a tertiary care hospital, in western India over a period of 2 years. Maternal age ranged between 25 years to 38 years and gestational age ranged between 6 weeks to 10 weeks. Seven patients presented with symptoms like bleeding per vaginum and/or lower abdominal pain and three patients were asymptomatic. Transvaginal sonography was done for confirmation of diagnosis. In all patients, beta hCG levels were done on the first day. 4 patients were initially treated by medical management but was unsuccessful. Surgical management was done by laparotomy in 9 patients and in 1 patient laparoscopy. Treatment should beindividualized depending on severity of symptoms, beta hCG level, patient’s condition, and surgeon’s experience. Keywords: Cesarean scar pregnancy, Beta hCG, Ultrasonography